Recurrent acute pancreatitis as an initial presentation of primary hyperparathyroidism: A case report

Background: With 4.9 to 35 instances per 100000 cases, hyperparathyroidism is one of the rarest causes of acute pancreatitis. The major cause of primary hyperparathyroidism is a parathyroid adenoma, which can manifest clinically in various ways.

Case summary: We discuss the unusual case of a 13-year-old boy with recurrent pancreatitis as the initial presentation of primary hyperparathyroidism. The cause of his recurrent pancreatitis remained unknown, and the patient had multiple admissions with acute pancreatitis over 3 years. His diagnosis was delayed due to the initial normal levels of parathyroid hormone, which were later reported elevated in a subsequent episode where ultrasound neck and thyroid scintigraphy revealed a parathyroid adenoma as the underlying cause. After the diagnosis was made, he underwent surgical resection of the adenoma.

Conclusion: This case study stresses the importance of considering uncommon causes for recurrent pancreatitis.